Plasma Lipoproteins and Its Metabolic Disorder

AS

[] [] [] [] 6

951. 2. 3. 4. 5. 6. 51. 2. 3.

(triglyceride, TG)

(free cholesterol,FC)

cholesterol ester, CE)

(TC)

(phospholipid, PL)

(free fatty acid, FFA)

() plasma lipids (glycolipid)

1 +(TGPLFC+CE) (1) HDL>LDL>VLDL>CM CM>VLDL>LDL>HDL (2) (Apo)()

2 ApoPL(PL) (TGCE)PL ApoPLFC Apo

, TGCE PLFFA

HDL LDL VLDL Lp(a) IDL

CM VLDL LDL HDL CM - LP-LP-LP

(ultra centrifugation method)(density-gradient method) Sf (Svedberg floatation rate)

Sf

d(g/ml)

CM

>400

(electrophoresis method)

TGrich LipoproteinChrich Lipoprotein

CM, , CM (), AS

VLDL

LDL,ASASLDL

HDL HDLAS,

() ()

()(apolipoproteinApo) 12 1972AlaupovicApoABCDEFGHJ

apoAapoAapoAapoAapoAapoAapoAHDL

apoBapoB100apoB48apoB100LDLapoB48CM

apoCapoCapoCapoCapoCVLDLapoB100apoC apoD apoEapoE2apoE3apoE4

3 LCATapoAapoAapoCapoALpLapoCapoAapoCHLapoA

apoBapoBELDLapoEapoBEapoELDLLRPapoAHDL

CETPHDLVLDLLDLPTPCMVLDLHDL apoDLCATapoAapoA-apoD-LCAT

() genotype ()(Phenotype)

1

( 1 )ApoAApoBApo(a)

(intron) 3

(exon) 4

( 2) ApoACA112 ApoECC193

2 ( 1 ) ApoA 1 863bp34 658bp ApoAApoA 11

( 2 ) ApoB 2ApoB100 43kb2829 7 572bp39bp

( 3 ) ApoE 1934 ApoE3 ApoE2ApoE3ApoE4 E2/2E3/3()E4/46 E2/3E2/4E3/4 ( 4 ) ApoC ApoCApoC3347bp 3133bp3,4

( 5 ) Apo(a) 6 525kb1918 Apo(a)2634

ApoCIApoA

*A 11q23-qApoAA1 q23-q23ApoAA11ApoA(a)6Apo(a)B2q24-q23ApoBC19q13.2ApoCC19ApoCC11ApoCD 3ApoDE19q13.2ApoEH 17q23-qApoHJ8p21CL

ApoEApoC ApoCII

19q311q2 , , , ApoCApoAApoAApoA

LDLVLDL

LDLLDL receptor 1974 LDL 1LDL 836115kD5

2LDL1 coated pit ;

(2) ApoB100ApoE ApoB-E ApoB48 LDLApoB100LDLLDL ApoB/ELDL

3LDLLDL receptor pathway 1LDLApoB100EVLDL-VLDLLDLLDL-VLDLVLDL-LP CEApoApoEApoCVLDL

2LDL LDL+LDL LDL-LDLcoated vesicles LDLLDLLDL Apo CE FFA+FC TG +FFA

(3) FC Ch HMGCoA ACATCoAFCCE LDLLDLLDL

4 LDLLDL VLDL CM LDLCMCMApoB48LDLApoEApoCLDLCM

VLDL 1 LDL5 2 ApoEVLDL-VLDLApoB100LDL Ch

3 VLDL-VLDL 4 1As 2

scavenger receptor LDL LDL LDL AsLDL-CELDLLDLLDLLDLLDL

1

220 ku,, LDLN-C-inside-out6N-C

2 1LDL LDLLDLox-LDLAs 2

3 LDLox-LDLAs LDL

HDL(RCT) VLDL-IDL-LDLVLDL, IDLLDL,CMChTGCMLP

(CM)

TG TGTG :

CM

()VLDL1.2.TG(50%-70%)ApoB100ChCM3.TG 4.

VLDLHDL IDL

VLDL TGVLDL

() LDL1.VLDL2. Ch(45%-50%)CEHDL(CETP) APOApoB100 3.4. (1) LDL

2 LDLLDLLDLLDL (ox-LDL)(scavenger receptor, SR)LDL* 45%LDL2/3LDL1/3

LDL

LDL

LDL,LDLLDL

()HDL 1. 2. 3. HDLApoEApoC HDLHDL 4.

HDL

HDLHDL3 HDL2 LCAT CETP

Hyperlipoproteinemia Hyperlipidemia TG/TC

:

ApoLP WHOab

()CM 1. 1LPL 2ApoC Apo C() LPL CMTG CMCM CM 2.

3.14CM 2TG 3CM 4CM 5LPLLPLApoC

()IIa1. LDL (1) LDL (2) LDLLDL (3) LDL LDLLDL LDLLDL-Ch AS

2. ASAS3.12 TG34LDL ApoB

() b-LP -LP 1.: ApoB100VLDLLDL 2. baLDL

3. (1 2 TG 3LPPre LP 4 LDL VLDL

() (-VLDL-) 1. ApoE ApoEApoE2E3E4ApoE(VLDL)E2VLDLApoE3/E3VLDLApoE2/E2VLDLVLDL

2.AS3.1 2TG Ch 3-VLDL LPPre LP--VLDL4 IDL (-VLDL)

() (TG VLDL) 1. VLDL/VLDL

2.142 TG Ch 3 Pre 4 VLDL VLDL

3.

() (CM-LP) 1. ApoC LPL CMVLDL TG LPL

2. 203050

3.12TG Ch 3CM 4CM VLDL

() HDL HDLASASHDLHDL 1 HDL-Ch> 2.6mmol/L0.78-2.2mmol/L0.3-0.85g/L

2 (1) CETPCETPHDL-CEHDL, HDL HTGL, HDL, HDL HDL, HDL-ch(3~5) (2)

CETP HTGL HDL HDL-C2.6mmol/LHDL CETPHTGLHDL

HDL

(secondary hyperlipoproteinemia) () , () () ()

VLDLLPLCMVLDLTG TG

ab: LPL,VLDL; HTGL,IDL; LDL,LDL

Cushing VLDLVLDLLDLa b

ApoBVLDLVLDLLDLb LPLVLDL

AS AS HDLAS

ASASLDL-VLDL oxLDLAS HDLAS AS

AS

CMVLDLLPLCMIDLApoE -VLDL(ApoE)-VLDLASAS

LDL LDLLDLLDL,LDL: LDL LDL LDL LDLApoB100LDLLDLAS

LDL-CAS LDLAB: B(LDL)AS,BLDL,LDLLDLCHD LDL(SD-LDL) BLDL

(a)LP-(a)Lipoprotein(a) 1963LDL

TGPLFCCE ApoB100Apo(a)()

LDL

LP(a)As,Apo(a)As

1 2LDL 3 4 5 6 HDLAS

HDLApoAIApoB

HDL: CENCEHFCHDLNCEH FC: NCEH NCEH

ASAS

TCTGHDL-CLDL-C ApoAIApoBLpa TCTGHDL-CLDL-C 4 TCTG

CDC

12h4

() (CEH)(cholesterol oxidaseCOD)4H2O2(POD) H2O24-(4AAP)(PAP)500nm

-4060001-2 C

2.85.2mmolL

112020405070234

21TC - CoA 2TC

() -----GPO-PAP

C

0.55-1.70mmol/L 2.30mmol/L 4.50mmol/LTG

1TG TGCHDTG 2TG

() .

()---LDLVLDLLp(a)HDL(TC)HDL(HDL-C)HDLTGpH4h

HDL-C 0.9mmol/L

:(1)HDL-CHDL-C0.9mmolL(2)HDL-C(3)TGHDL-C4HDL-C5HDL-C6HDL-C

()-----Friedewald

LDL-CTCHDL-CTG2.2(mmolL) FriedewaldLDL-CTCTGHDL-CLDL-C CMTG>4.52mmolL(400mgd1)-FriedewaldLDL-C

LDL-C 2.13.1mmol/L 2.8mmol/L

: LDL(LDL-C)LDLLDL-CTCLDL-CLDL-CLDL-C

AIB ApoAIApoBApoAApoBApoAIApoBApoAIApoB

ApoAI1.00~1.50gLApoB0.80~1.00gL

ApoAIHDLHDLApoBLDLLDLLDLApoAIApoB,HDL-CLDL-CApoAIApoBApoAIApoB

1 2ApoAAB100 C 3LDL??LDL??? 4CM VLDL LDL HDL 5? 6? 7APOA1APOB100HDLLDL

1.063g/ml(1.75mol/L Nacl)1.063 1.063(HDL) Sf LDL VLDLLDL LDL VLDLLDL

1 ApoB100/ApoE,ApoB100ApoELDLligand VLDLVLDL-VLDL2EGF 3 4 5 C- LDL,LDLLDL